My husband has used Actos for almost 14 years. It does work for him, but it is expensive. Since our insurance doesn't pay for Rx's until we hit our deductible we have to pay the full price. At a US pharmacy the Actos costs us close to $220 per month. We now buy it in Canada for $188 for a 3 month supply. Usually doctors will prescribe metformin first since it is generic and very cheap. I would insisit your doctor writes an Rx for the metformin or find a new doctor that will. That is a big HbA1c drop in a month and I am sure if you stick to a lower carb diet and add exercise it will fall further.